SC-6.4(C) Sex Offender Special Conditions of Probation SEX OFFENDER SPECIAL CONDITIONS OF PROBATION These conditions are hereby incorporated into the Defendant's sentence by reference. The Defendant is advised that violation of any Special Condition of Probation may subject the Defendant to a revocation of the balance of the period of probation and the Defendant may be required to serve up to the balance of the sentence in confinement. (Judge to designate conditions to be applied.) 1. _____ Contact with minors. You shall have no contact, whether directly in person or indirectly through any means of communication, with any child under the age of eighteen (18), including your own children, nor with any person unable to give consent because of mental or emotional limitations. Neither shall you attempt contact with the aforementioned except under circumstances approved in advance and in writing by the Court. If you have incidental contact with children, you will be civil and courteous to the child and immediately remove yourself from the situation. You will discuss the contact at your next meeting with your Probation Officer. 2. _____ Residence with a minor. You shall not reside with any child under the age of eighteen (18), including your own children, unless approved in advance and in writing by the Court. 3. _____ Residence change. You shall not change your residence without receiving prior approval by your Probation Officer. 4. _____ Victim contact. You shall have no contact with the victim, including correspondence, telephone contact, any form of electronic communication, or communication through a third party except under circumstances approved in advance and in writing by the Court. You shall not enter the premises, travel past, or loiter near where the victim resides. 5. _____ Employment. Your employment must be approved by your Probation Officer. 6. _____ Images of minors. Except as authorized by the Court or the Probation Officer, you shall not create, possess, access or control any type of photograph, video, rendering, or digital imagery of any minor. 7. _____ Relationships. You shall not date or marry anyone who has a child or children under the age of eighteen (18), unless approved in advance and in writing by the Probation Officer in consultation with the treatment provider or the sentencing Court. You are required to notify any such person of your criminal history. State of Georgia v. __________________ Criminal Action # ___________________ Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com 8. _____ Sexually oriented material. You shall not possess or subscribe to any sexually oriented or sexually stimulating material to include mail, computer, or television, nor patronize any place where such material or entertainment is available. 9. _____ 900 numbers and post office boxes. You shall not utilize "900" telephone numbers. You shall not rent a post office box without permission in advance and in writing from your Probation Officer. 10. ____ Curfews. You shall abide by any curfew imposed by the Probation Officer. 11. ____ Evaluation and treatment. You shall attend and actively participate in sex offender evaluation and treatment at a program approved by the Probation Officer. You will abide by the rules of the treatment program and successfully complete the program to the satisfaction of the Probation Officer and the treatment provider. You will be financially responsible for all evaluations and treatment unless other arrangements have been made by your Probation Officer or treatment provider. 12. ____ Polygraph/plethysmograph. You shall submit, at your own expense, to any program of psychological or physiological assessment at the direction of the Probation Officer or treatment provider. This includes the polygraph and/or the plethysmograph to assist in treatment, planning, and case monitoring. 13. ____ Release of information. You shall sign releases of information to allow the Probation Officer to communicate with other professionals involved in your treatment program and to allow all professionals involved to communicate with each other. This will include a release of information to the therapist of the victim. 14. ____ Search. You shall submit to a search of your person, property, residence, or vehicle at any time of the day or night, with or without consent or a search warrant, whenever requested to do so by a Probation Officer or any other peace officer. You specifically consent to the use of any contraband seized as evidence in a probation violation proceeding. 15. ____ Alcohol. You shall not purchase, possess, or consume alcoholic beverages. 16. ____ Drugs. You shall not take into your body any controlled substance or mind altering drug except pursuant to a legal doctor's prescription. 17. ____ Drug or alcohol screens. You shall submit to, and if necessary pay for, breath, urine, blood, or saliva tests for analysis for the possible presence of a prohibited drug or alcohol. State of Georgia v. _________________ Criminal Action # __________________ SC-6.4(C) Sex Offender Special Conditions of Probation Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com 18. ____ Driving log. You shall keep a driving log and make it available to your supervising Probation Officer as requested. 19. ____ Driving. You shall never drive alone, especially through parks, playgrounds, school zones, or other areas where children are commonly known to be. 20. ____ Hitchhiking. You shall not hitchhike or pick up hitchhikers. 21. ____ Other special condition(s). _____________________________________ _____________________________________________________________ _____________________________________________________________ SO ORDERED this _____________ day of _________________________, 20______. _____________________________________ Judge of Superior Court _________________________ Judicial Circuit _____________________________________ (print or stamp Judge's name) Acknowledgment: I have read the terms of this document or had them read and explained to me. I understand that violation of a special condition of probation could result in revocation of all time remaining on the period of probation. _____________________________ Defendant State of Georgia v. _________________ Criminal Action # __________________ SC-6.4(C) Sex Offender Special Conditions of Probation Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com